Analysis Of Abnormal Origin Of Coronary Artery And Its Correlation With Atherosclerotic Plaque

Objective: Dual source CT angiography was used to observe the prevalence and anatomical characteristics of abnormal origin of coronary artery,and to explore the relationship between abnormal origin and the formation of coronary atherosclerotic plaque,so as to provide the corresponding basis for the best clinical treatment and management strategy.Methods: The data of successful coronary angiography in our hospital from January 2014 to December 2019 were analyzed retrospectively,and the patients with abnormal origin of coronary artery were screened.The characteristics of CT angiography were studied by using CT raw data through post-processing such as maximum intensity projection(MIP),multiplanar reconstruction(MPR),curved surface reconstruction(CPR)and volume rendering(VR).71 patients with normal coronary artery origin were randomly selected as the control group to compare the common variations in the abnormal origin of coronary artery with the occurrence of plaques on the three main coronary arteries in people with normal coronary origin.Patients with complex congenital heart disease and patients with coronary stents were excluded.Results: In the analysis of 7235 cases of coronary artery CT angiography,abnormal coronary artery origin was detected in 87 cases,with a detection rate of 1.2%,including 50 males(57.5%)and 37 females(42.5%).In 3861 male subjects,the incidence of AOCA was 1.3%;in 3374 female subjects,the incidence of AOCA was 1.1%,the difference was not statistically significant.In the classification of abnormal origin of coronary artery,abnormal coronary sinus was found in 34 cases,with a detection rate of 39.1%.The right coronary artery originated from the left coronary sinus was the most common,with a variety of high-risk anatomical features.for example,the initial segment runs between aorta and pulmonary artery,intramural segment,fissure-like opening,proximal stenosis,acute starting angle,which can easily lead to myocardial ischemia,palpitation,chest pain and other discomfort,and even sudden death.High origin was found in 30 cases(34.5%),absence of left trunk in 21 cases(24.1%),origin of pulmonary artery in 1 case and single coronary artery in 1case,with a detection rate of 1.2%.There was no significant difference in the incidence of atherosclerotic plaques in the three main coronary arteries between the abnormal coronary artery origin group and the normal coronary artery origin group by chi-square test(P > 0.05).Conclusion: Coronary artery CT angiography(CTA)can well show the abnormal origin and characteristics of coronary artery,can achieve non-invasive,rapid,accurate and intuitive diagnosis of patients with abnormal origin of coronary artery,and can provide important information for guidance and decision-making of the best treatment.There is no gender difference in the origin variation of coronary artery.Abnormal origin of coronary sinus is the most common variation,accompanied by multiple high-risk anatomical structures,which is more prone to chest pain and cardiovascular events,so care should be taken.There was no significant correlation between abnormal origin of coronary artery and atherosclerotic plaque.